This sheet is about having mpox in a pregnancy or while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.
What is mpox?
Mpox (which used to be called monkeypox) is an illness caused by the mpox virus (MPXV). MPXV belongs to a group of viruses called orthopoxviruses.
Symptoms of mpox can begin 5 to 21 days after being exposed to the virus, but most people start having symptoms in 7 to 14 days. The first symptoms to appear include: fever, headache, muscle aches, backache, swollen lymph nodes (“glands”), chills, and exhaustion (being very tired). A few days after these symptoms start, a skin rash appears on the body, often starting near the genitals or on the face. The rash causes bumps and sores that can be itchy and painful and that gradually turn into scabs that fall off. In most people, the illness lasts 2 to 4 weeks before clearing up on its own. However, for some people, mpox can cause severe illness and even death. Women who are pregnant are more likely to have more severe illness than others.
How do you get mpox?
Mpox spreads from person to person through body fluids. This can include direct contact with the skin sores or scabs of an infected person, from the fluids that come from these sores (such as on clothing or bedding), or through saliva and respiratory droplets (such as kissing or being in close contact with someone with mpox when they breathe, talk, cough, or sneeze). Mpox can also spread through intimate or sexual contact with a person with mpox.
How can I protect my pregnancy from mpox?
The Centers for Disease Control and Prevention (CDC) recommends the following:
- Avoid close or intimate contact with people who have a rash that looks like mpox.
- Avoid animals that can carry the virus.
- Do not use objects or materials a person with mpox has used.
- Wash your hands well and often
A vaccine for mpox is available and recommended for some groups of people. More information can be found on the CDC’s website on mpox vaccination here: https://www.cdc.gov/poxvirus/mpox/vaccines/vaccine-recommendations.html.
What should I do if I think I have been infected with mpox?
It is important that you seek medical attention if you think you have mpox. Treatment for mpox will depend on your symptoms. The CDC has recommended that women who are pregnant, recently pregnant, or breastfeeding, who need treatment for mpox, should be offered antiviral medication. There is an increased risk of more severe illness in women who are pregnant and have mpox. Be sure to talk to your healthcare provider about what mpox treatment is best for you.
I have mpox. Can it make it harder for me to become pregnant?
It is not known if having mpox can make it harder to get pregnant. There are no official recommendations to wait to get pregnant after having mpox. However, Mpox can be passed to a fetus during pregnancy. Talk with your healthcare provider about your plans to try and get pregnant.
Does having mpox increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. It is not known if having mpox can increase the chance of miscarriage. Infection during pregnancy with other viruses related to mpox (such as smallpox) has been found to increase the chance of miscarriage.
Does having mpox increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. It is not known if having mpox can increase the chance of birth defects.
Fever is a possible symptom of mpox. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen is usually recommended to reduce fever in pregnancy. If you have a fever, talk with your healthcare provider about how to treat it during pregnancy. For more information about fever and pregnancy, see the MotherToBaby fact sheet about hyperthermia at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/ and a fact sheet on acetaminophen here: https://mothertobaby.org/fact-sheets/acetaminophen-pregnancy/.
Would having mpox increase the chance of other pregnancy-related problems?
Mpox infection has not been well-studied in pregnancy. There is 1 case report of a stillbirth and 1 case report of a preterm delivery (birth before week 37) after infection with mpox during pregnancy. In both cases, the babies also had signs of mpox infection. Infection during pregnancy with other viruses related to mpox (such as smallpox) has been found to increase the chance of stillbirth and preterm delivery. It is not known if mpox infection can cause other pregnancy-related problems, such as low birth weight (weighing less than 5 pounds, 8 ounces (2500 grams) at birth).
Can the virus that causes mpox pass to the baby during pregnancy or at the time of delivery?
When a woman is pregnant and passes an infection to the fetus, it is called vertical transmission. Vertical transmission can happen at any time in pregnancy but is more likely to happen when someone gets the infection close to delivery.
Vertical transmission has been reported with mpox infection in pregnancy. In the 2 case reports described above, the mpox virus passed to the babies during pregnancy and caused symptoms that included skin sores. It is not known how often a mpox infection might pass to a fetus during pregnancy or at the time of delivery, or how likely it is to cause problems during pregnancy or after birth.
Does having mpox in pregnancy affect future behavior or learning for the child?
Studies have not been done to learn if having mpox in pregnancy can increase the chance of behavior or learning issues for the child.
Breastfeeding while I have mpox:
It is not known if the virus that causes mpox gets into breast milk, or if having skin sores on or near the nipples or breasts could cause the virus to get into milk that is expressed or pumped. However, the virus can be passed to an uninfected infant through close contact with a person who is infected (such as holding the baby to breastfeed). If you have mpox, talk with your baby’s healthcare provider about the best way to feed your baby until you recover. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man has mpox, can it affect fertility or increase the chance of birth defects?
Studies have not been done to see if having mpox could affect a man’s fertility (ability to get a woman pregnant) or increase the chance of birth defects above the background risk. Mpox can spread through intimate or sexual contact. Talk with your healthcare provider as soon as possible if you or your partner has mpox. For general information on paternal exposures, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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